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Neonatal and Pediatric Candidemia: Results From Population-Based Active Laboratory Surveillance in Four US Locations,

Kaitlin Benedict1, Monika Roy1, Sarah Kabbani2

  • 1Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

Journal of the Pediatric Infectious Diseases Society
|March 10, 2018
PubMed

Insights

Pediatric candidemia, a bloodstream infection, saw declining incidence in infants and children after 2009. However, rates stabilized from 2012-2015, with uncommon antifungal resistance. Further research is needed to understand these trends.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Pediatric Health

Background:

  • Candida species are a major cause of healthcare-associated bloodstream infections (candidemia) in the US.
  • Pediatric populations exhibit unique risk factors and Candida species distribution compared to adults.
  • Recent epidemiological data on pediatric candidemia is limited.

Purpose of the Study:

  • To describe the epidemiology of candidemia in children in the United States.
  • To analyze trends in incidence, clinical features, species distribution, and antifungal drug resistance.
  • To provide updated insights into a critical pediatric infection.

Main Methods:

  • Active, population-based candidemia surveillance was conducted in four US metropolitan areas from 2009 to 2015.
  • Incidences were calculated for neonates (0-30 days), infants (0-364 days), and noninfant children (1-19 years).
  • Clinical features and antifungal drug resistance patterns were documented.

Main Results:

  • A total of 307 pediatric candidemia cases were identified.
  • Incidence decreased in neonates and infants after 2009, stabilizing between 2012-2015. Noninfant children showed a steady decrease.
  • Common conditions included prematurity (neonates), surgery (infants), and malignancy (children). *Candida albicans* dominated neonate cases, while non-*C. albicans* species were more frequent in older children. Antifungal resistance was low, with a 30-day crude mortality of 13%.

Conclusions:

  • Candidemia incidence in neonates and infants declined post-2009 but stabilized in recent years (2012-2015).
  • Antifungal drug resistance remains uncommon in pediatric candidemia.
  • Further investigation is warranted to understand the reasons behind the lack of continued decline in neonatal and infant candidemia incidence.
Abstract

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